- Title
- Patient characteristics, short-term and long-term outcomes after incident heart failure admissions in a regional Australian setting
- Creator
- Al-Omary, Mohammed S.; Majeed, Tazeen; Al-Khalil, Hafssa; Sugito, Stuart; Clapham, Mathew; Ngo, Doan T. M.; Attia, John R.; Boyle, Andrew J.; Sverdlov, Aaron L.
- Relation
- Open Heart Vol. 9, Issue 1, no. e001897
- Publisher Link
- http://dx.doi.org/10.1136/openhrt-2021-001897
- Publisher
- BMJ Group
- Resource Type
- journal article
- Date
- 2022
- Description
- Aims: This study aims to (1) define the characteristics of patients with a first admission for heart failure (HF), stratified by type (reduced (HFrEF) vs preserved (HFpEF) ejection fraction) in a regional Australian setting; (2) compare the outcomes in terms of mortality and rehospitalisation and (3) assess adherence to the treatment guidelines. Methods: We identified all index hospitalisations with HF to John Hunter Hospital and Tamworth Rural Referral Hospital in the Hunter New England Local Health District over a 12 months. We used the recent Australian HF guidelines to classify HFrEF and HFpEF and assess adherence to guideline-directed therapy. The primary outcome of the study was to compare short-term (1 year) and long-term all-cause mortality and the composite of all-cause hospitalisation or all-cause mortality of patients with HFrEF and HFpEF. Results: There were 664 patients who had an index HF admission to John Hunter and Tamworth hospitals in 2014. The median age was 80 years, 47% were female and 22 (3%) were Aboriginal. In terms of HF type, 29% had HFrEF, 37% had HFpEF, while the remainder (34%) did not have an echocardiogram within 1 year of admission and could not be classified. The median follow-up was 3.3 years. HFrEF patients were predominantly male (64%) and in 48% the aetiology was ischaemic heart disease. The 1-year all-cause mortality was 23% in HFpEF subgroup and 29% in HFrEF subgroup (p=0.15). Five-year mortality was 61% in HFpEF and HFrEF patients. Of the HFrEF patients, only 61% were on renin-angiotensin-aldosterone blockers, 74% were on β-blockers and 39% were on aldosterone antagonist. Conclusion: HF patients are elderly and about evenly split between HFrEF and HFpEF. In this regional cohort, both HF types are associated with similar 1-year and 5-year mortality following incident HF hospitalisation. Echocardiography and guideline-directed therapies were underused.
- Subject
- patients; heart failure; echocardiography; admissions; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1487074
- Identifier
- uon:52044
- Identifier
- ISSN:2053-3624
- Rights
- x
- Language
- eng
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